Individual provider Active NPI

Erum Khalid, D.O.

  • Family Medicine Physician
  • Bronx, NY
National Provider Identifier
1043662323
Registry record updated Oct 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
BP1005582 Issued in TX
Practice address
730 Brook Ave
Bronx, NY 10455-1333
Phone
(214) 770-6089
NPI assigned
Jul 11, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 299957 NY
Family Medicine Physician 207Q00000X BP1005582 TX Primary

Addresses

Primary practice location

730 Brook Ave
Bronx, NY 10455-1333

Mailing address

2136 Creekside Cir S
Irving, TX 75063-3388

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190925001411 NY Practitioner - Family Practice 7113257742 Reassigns benefits to 1 organization
I20211102001275 TX Practitioner - Family Practice 7113257742 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
William Carey University College of Osteopathic Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

6301 Gaston Ave
Suite 300
Dallas, TX 75214-6227
Phone (469) 800-7900

Hospital & facility affiliations

  • Baylor University Medical Center Hospital, Dallas, TX, CCN 450021
  • Baylor Scott & White Institute for Rehabilitation Inpatient rehabilitation facility, Dallas, TX, CCN 453036

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
BP1005582TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network Family Medicine CurrentSince Nov 8, 2021 Accepting new patients
Healthtexas Provider Network Family Medicine Current Accepting new patients
Healthtexas Provider Network CurrentSince Nov 8, 2021 Accepting new patients
Montefiore Medical Center CurrentSince Aug 16, 2019 Accepting new patients
Montefiore Medical Center CurrentSince Aug 16, 2019 Accepting new patients

Locations

730 Brook Ave
Bronx, NY 10455
Phone (718) 484-1247

111 E 210th St
Bronx, NY 10467

6301 Gaston Ave
Ste 300
Dallas, TX 75214
Phone (469) 800-7100

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

301 N Washington Ave
Fl 5
Dallas, TX 75246
Phone (469) 800-8742

Interoperability endpoints

  • Direct secure messaging: ekhalid876074@direct.sw.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570752000000",
    "number": "1043662323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2136 CREEKSIDE CIR S",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750633388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 BROOK AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104551333",
            "telephone_number": "214-770-6089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALID",
        "first_name": "ERUM",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-11",
        "last_updated": "2019-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "299957",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "BP1005582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.